Preliminary Clinical Study of Monopolar Versus Bipolar Fractional Microneedling Radiofrequency for Facial Rejuvenation

Abstract

Objective: Fractional microneedling radiofrequency (FMR) is a promising minimally invasive treatment for skin rejuvenation. This pilot study aims to investigate and compare the efficacy and safety of monopolar versus bipolar FMR in the treatment for facial rejuvenation. Methods: In this prospective, split-face pilot study, 20 female patients aged 35–55 years were enrolled. Participants underwent a single session with one side of the face receiving monopolar FMR and the other side receiving bipolar FMR randomly. Post-treatment assessments for biometric and aging characteristics using Corneometer, Tewameter, Cutometer, Antera 3D, and VISIA, as well as blinded investigators’ evaluation and patients’ assessed improvement, were conducted at 40 ± 7 days after the procedure. Adverse effects were monitored 3–6 days after treatment. Results: Nineteen participants completed this trial. 40 ± 7 days post-treatment, a significant increase in overall skin elasticity was noted on both sides of the face. No significant changes were observed in skin hydration, transepidermal water loss (TEWL), melanin, and erythema indices, and no differences were noted between the monopolar and bipolar groups. Antera 3D showed a significant reduction in average pore count, density, size, and volume in the bipolar group and in average pore density and volume in the monopolar group. Both modes of FMR significantly improved small textures (monopolar: 7.11 ± 1.45 to 6.58 ± 1.17, bipolar: 7.12 ± 1.23 to 6.55 ± 1.22; p < 0.05, p < 0.05). Significant improvements in small wrinkles and texture were also detected. Bipolar FMR showed superior results in pore count, size, and volume compared to monopolar FMR but was associated with significantly more pain. Patients reported overall satisfaction post-treatment, with no significant difference between the two sides. After the procedure, mild to moderate erythema and edema were noted, without any severe side effects. Scab formation occurred exclusively on the bipolar-treated side. Conclusion: Monopolar and bipolar FMR are effective and safe for addressing aging with minimal adverse effects. Bipolar FMR offers better outcomes in terms of facial pores but may cause higher discomfort and longer recovery periods. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2300069921.